LI hospital monitors workers' hand-washing

Hand washing by health care workers -- the key to infection control -- is being eyed by cameras at a Long Island hospital where a monitor displays compliance in the latest high-tech step to enforce hygiene.

Dr. Bruce Farber, chief of infectious disease at North Shore University Hospital in Manhasset, had the system installed and received a $50,000 grant from the state health department to study it as part of a recently completed hand-hygiene research project.

Results of his investigation, published in the current edition of the journal Clinical Infectious Diseases, shows that staff members' hand-washing improved dramatically with electronic eavesdropping.

Cameras are strategically mounted to capture shots of doctors and nurses as they enter and exit the medical and surgical intensive care units. Each shift's compliance is recorded in real time on LED monitors, which are prominently displayed.

"Part of the criteria in this study," Farber said, "was that all employees had to wash their hands before and after going into a patient's room, and they had to do it each time within 10 seconds."

Under an electronic eye, hand-washing has soared to nearly 90 percent. The monitor updates every 10 minutes, noting staff compliance. Only positive performance messages are noted on the LED board, Farber added.

Hand hygiene is critical in hospitals, Farber said, where doctors and nurses can potentially transfer microorganisms from one patient to another, often on their hands.

With an emphasis on hand hygiene, Farber said, infections involving the superbug MRSA, methicillin-resistant Staphylococcus aureus, have dramatically declined, and so have those involving the notorious spore-producing bacterium, C. difficile.

The Centers for Disease Control and Prevention estimates 1 in 20 patients develop hospital-acquired infections.

Before the electronic surveillance, Farber said North Shore used the equivalent of a "secret shopper," such as undercover employees in department stores, by designating a staff member to note how well workers abided by hand-washing rules. And while the secret nurse or doctor reported rates of about 60 percent, an initial run of the electronic system revealed a dismal rate of only 6.5 percent.

North Shore is one of two major teaching hospitals nationally to use the electronic system, which is the brainchild of Adam Aronson, founder and chief executive of Arrowsight, a Mount Kisco company. The other hospital is in California.

He has produced a similar system for the meatpacking industry where worker hygiene is also critical. Auditors in Alabama or India watch video as it streams from cameras -- including those at North Shore -- and score workers on hygiene compliance.

The idea for hospital surveillance was first suggested to Aronson by his father, a Harvard Medical School physician. But he didn't begin to develop it in earnest until two events rocked his life.

"Within the space of one year, both my mother and my sister had incredibly serious hospital-acquired infections, and that really woke me up," Aronson said.